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Biomedical subjects

D Serin

Publications and source records attributed to D Serin.

17 recordsLinked to original sources
PubMed1992

[Exclusive radiotherapy and brachytherapy in the treatment of breast cancer].

Exclusive radiotherapy is one of the modalities of conservative treatment for breast cancer. It is designed to destroy the tumour without surgery and to retain a treated breast comparable to the contralateral breast. The efficacy of radiotherapy, alone or in combination with brachytherapy, expressed in terms of overall survival and disease-free survival, has been documented by a large number of retrospective studies. The results published, especially by French teams, pioneers in this field, are comparable to the results reported for other conservative and radical techniques. The quality of the cosmetic results is inversely proportional to the dose delivered and decreases with the observation time. Although the cosmetic role of radiotherapy is modest, its therapeutic role remains essential in the case of initially or subsequently inoperable lesions. The current development of primary chemotherapy and rehabilitation techniques have limited the indications for exclusive radiotherapy plus or minus brachytherapy, but have paradoxically led to a renewed interest in this technique.

Brachytherapy↗
PubMed1992

[Current role of chemotherapy in the treatment of invasive cancers of the bladder].

Treatment of bladder carcinoma with cystectomy and or radiotherapy provide 5-year survival rates of 28-50%. Phase II chemotherapy trials have proven its efficacy with a partial and complete response rate of 20% and 10% respectively for drugs such as cisplatin or methotrexate. Recent phase III studies have demonstrated the superiority of associations such as CMV, CISCA or M-VAC with complete response rates of 28-39%. Neoadjuvant chemotherapy may increase local control and offer the possibility of conservative treatment after complete tumor regression (one third of cases). The positive effect of neoadjuvant chemotherapy on survival has not yet been demonstrated and randomized trials are now in progress. The concomitant association of cisplatin or fluorouracil with radiation therapy provides high complete response rates (65-88%) in all published studies. A longer follow-up period is necessary to confirm these results in terms of local control gain and survival benefit, but this strategy seems to constitute a major advancement for patients unable to undergo radical cystectomy. Further studies are needed before extending this conservative approach to less advanced invasive bladder carcinoma. Adjuvant chemotherapy may decrease metastasis rate, but survival benefit has not yet been definitively established by randomized studies.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

[Combination radiotherapy and chemotherapy in cancer of the pancreas. Review of the literature and prospects].

Overall prognosis of pancreatic adenocarcinoma is still very poor with median survival around 10 months after radical surgery in operable patients, or after full-dose radiation therapy in non-surgical candidates. In metastatic disease, multidrug chemotherapy regimens give a response rate of around 30% with median survival of 10 months. Random trials conducted by the GITSG in inoperable cases have shown improved results for chemoradiation with 5-FU for radiotherapy alone and a doubling of median survival with a 1-year survival of 40% vs 10%. Incorporation of Adriamycin in these combined modality protocols does not improve the results in terms of survival. Chemoradiation also shows improved results compared with chemotherapy alone. In patients amenable to radical surgery, adjuvant post-operative treatment with chemoradiation gave superior results over surgery alone with a doubling of median survival and a significant improvement of a two-year survival rate (42% versus 15%). Intra-operative radiation therapy leads to better local control but without a significant improvement in survival. With a better understanding of radio-chemotherapy interactions and mechanisms of radiosensitization through continuous infusion of fluorouracil and/or cisplatinum, these encouraging results should be confirmed within the next few years.

Adenocarcinoma↗
PubMed1990

[ A comparative lympho-scintigraphic evaluation of manual lymphatic drainage and pressotherapy in edema of the arm following treatment of a breast tumor].

Manual lymphatic drainage (MLD) and pressure-therapy are part of the therapeutical gears used in physiotherapy for reducing edema. The solution to the problem of the reduction fo lymphedema of the extremities rests with the evacuation of the liquid phase and the resorption of the stagnant proteins in the interstitial compartment not being collected by the lymphatic system. The injection of a 99 Technetium-labelled colloid substance provides a functional approach to the problem of lymphatic stasis.

Arm↗
PubMed1986

[The value of breast lymphoscintigraphy in the definition of axillary staging in cancer of the breast].

Axillary lymphoscintigraphy (ALS) has been investigated in 51 patients with operable breast carcinoma between July 1982 and February 1984. Pre-operative intra-tumoral injection of 2.5 cm Ci of technetium 99 m antimony sulfide colloid has been performed before axillary dissection. We compared the scans produced by ALS with the results of pre-operative clinical examination of the axilla (UICC criterias) and to the histological status of the nodes surgically removed. We focused on the statistical methodology because, for us, most of the studies use inadequate tests. Axillary lymphoscintigraphy did not predict axillary metastase in breast cancer with precision. Its score was under clinical exam. Today, we are not allowed to abandon axillary dissection for pre-operative ALS. That simple and non traumatic examination appeared to be of no value in order to determine the axillary metastatic nodal status in breast cancer.

Axilla↗
PubMed1985

[Chemotherapy of embryonal carcinoma of the testis with lymph node invasion and/or pulmonary metastases. Results of a VBP type protocol].

Fourteen patients with histologically proven embryonal carcinoma of the testis with pulmonary metastasis (10 pts) or para-aortic nodal involvement (4 pts) were treated by a chemotherapy regimen including vinblastine, bleomycin and cisplatin. Extreme ages were 19 and 51 years with a median age of 32 years. Median duration of treatment was 6 months (6 cycles of chemotherapy) without maintenance treatment. After completion of chemotherapy, 6 patients in complete remission received para-aortic node irradiation (45 Grays in 25 fractions). One patient had a para-aortic node dissection, histologically negative. With a median follow-up of 47 months (maximum 92 months, minimum 12 months), eleven patients are in complete remission (78.6%). Three patients are dead from the disease, in spite of salvage chemotherapy. There were no toxic deaths. Disease-free actuarial survival is 74% at 4 years. Our results confirm the excellent therapeutic results of this chemotherapy regimen in embryonal carcinoma of the testis with pulmonary metastasis and/or para-aortic nodal involvement.

Adult↗